Quantitative imaging in medicine and surgery · 2025
Retrospective study on preoperative hook wire localisation of pulmonary ground-glass nodules: risk factors for complications and preventive strategies.
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Wang Chuanxi, Chen Chang, Liu Gaohua, Li Zhiquan, Zheng Delai, Li Xiaoliang
Аннотация
BACKGROUND: Adjusting the angle of the trajectory needle may help reduce the occurrence of complications associated with preoperative hook and thread localisation. This study aims to examine the risk factors for complications associated with preoperative hook wire localisation of pulmonary ground-glass nodules (GGNs).
METHODS: In this single-centre retrospective study, an analysis was conducted on 230 preoperative hook wire implantations for 230 pulmonary GGNs. We assessed the angle of needle trajectory by analysing the computed tomography (CT) images at the point of needle insertion. We evaluated the main variables related to patient demographics, lesion size and location and preoperative conditions to determine the risk factors for complications. Univariate and multivariate logistic regression analyses were used to establish a predictive model to evaluate the incidence of hook wire localisation complications.
RESULTS: A total of 230 patients were included in the final analysis. Pneumothorax and intrapulmonary hemorrhage were the primary complications, occurring in 38.7% and 18.7% of cases, respectively. The results from the multivariate logistic regression analysis demonstrated a positive correlation between the needle insertion angle and the occurrence of pneumothorax [odds ratio (OR): 1.035, 95% confidence interval (CI): 1.008-1.063, P=0.011] as well as intrapulmonary hemorrhage (OR: 1.057, 95% CI: 1.020-1.095, P=0.002). Pneumothorax was associated with factors such as emphysema (OR: 12.286, 95% CI: 3.687-40.938, P<0.001), the nearest pleural distance (OR: 0.944, 95% CI: 0.907-0.983, P=0.005), and the number of punctures (OR: 3.443, 95% CI: 2.006-5.907, P<0.001). Similarly, pulmonary hemorrhage was correlated with variables such as the number of punctures (OR: 1.894, 95% CI: 1.080-3.322, P=0.026), chest wall access thickness (OR: 0.951, 95% CI: 0.915-0.988, P=0.010), and the length of intrapulmonary access (OR: 1.060, 95% CI: 1.016-1.106, P=0.007).
CONCLUSIONS: In summary, reducing the needle trajectory angle can alleviate complications linked to preoperative hook wire localisation, and employing predictive models before puncture site selection, along with strategic needle insertion planning, can effectively minimise procedural risks.
METHODS: In this single-centre retrospective study, an analysis was conducted on 230 preoperative hook wire implantations for 230 pulmonary GGNs. We assessed the angle of needle trajectory by analysing the computed tomography (CT) images at the point of needle insertion. We evaluated the main variables related to patient demographics, lesion size and location and preoperative conditions to determine the risk factors for complications. Univariate and multivariate logistic regression analyses were used to establish a predictive model to evaluate the incidence of hook wire localisation complications.
RESULTS: A total of 230 patients were included in the final analysis. Pneumothorax and intrapulmonary hemorrhage were the primary complications, occurring in 38.7% and 18.7% of cases, respectively. The results from the multivariate logistic regression analysis demonstrated a positive correlation between the needle insertion angle and the occurrence of pneumothorax [odds ratio (OR): 1.035, 95% confidence interval (CI): 1.008-1.063, P=0.011] as well as intrapulmonary hemorrhage (OR: 1.057, 95% CI: 1.020-1.095, P=0.002). Pneumothorax was associated with factors such as emphysema (OR: 12.286, 95% CI: 3.687-40.938, P<0.001), the nearest pleural distance (OR: 0.944, 95% CI: 0.907-0.983, P=0.005), and the number of punctures (OR: 3.443, 95% CI: 2.006-5.907, P<0.001). Similarly, pulmonary hemorrhage was correlated with variables such as the number of punctures (OR: 1.894, 95% CI: 1.080-3.322, P=0.026), chest wall access thickness (OR: 0.951, 95% CI: 0.915-0.988, P=0.010), and the length of intrapulmonary access (OR: 1.060, 95% CI: 1.016-1.106, P=0.007).
CONCLUSIONS: In summary, reducing the needle trajectory angle can alleviate complications linked to preoperative hook wire localisation, and employing predictive models before puncture site selection, along with strategic needle insertion planning, can effectively minimise procedural risks.